Severe Plaque Research Articles

Role of <i>Actinomyces</i> species in oral Biofilm Formation and Dental Plaque-Related Diseases

Introduction: Actinomyces species play a major role in the development of oral biofilms and disorders associated with dental plaque. The purpose of this study was to look into their interactions, prevalence, and ability to form biofilms in dental plaque. Methodology: Dental plaque samples from 78 participants in a six-month cross-sectional research at KCD Peshawar were examined for Actinomyces species. The microtiter plate test was used to measure the production of biofilms, and statistical analyses were performed to investigate the relationships between Actinomyces presence, plaque severity, and biofilm formation capacity. Results: A total of 79.5% of samples contained Actinomyces species, with Actinomyces naeslundii being the most common (72.6%). Actinomyces was found to be significantly correlated with the severity of the plaque (χ² = 8.92, p = 0.012). In comparison to mild/moderate plaque (mean OD570 = 0.52, t(60) = 2.78, p = 0.007), isolates from severe plaque (mean OD570 = 0.61) formed more biofilms. Increased biofilm biomass was obtained through co-cultivation with Streptococcus mutans, particularly in combinations involving A. israelii and S. mutans. Conclusion: Actinomyces species are important in the development and severity of dental plaque, with more severe cases being associated with higher biofilm-forming capacity. Their relationships to Streptococcus mutans increase the pathogenicity of biofilms. Actinomyces targeting may be able to reduce tooth plaque-related illnesses. Larger populations and biological reasons for successful interventions should be investigated in future studies.

Patient-level explainable machine learning to predict major adverse cardiovascular events from SPECT MPI and CCTA imaging.

Machine learning (ML) has shown promise in improving the risk prediction in non-invasive cardiovascular imaging, including SPECT MPI and coronary CT angiography. However, most algorithms used remain black boxes to clinicians in how they compute their predictions. Furthermore, objective consideration of the multitude of available clinical data, along with the visual and quantitative assessments from CCTA and SPECT, are critical for optimal patient risk stratification. We aim to provide an explainable ML approach to predict MACE using clinical, CCTA, and SPECT data. Consecutive patients who underwent clinically indicated CCTA and SPECT myocardial imaging for suspected CAD were included and followed up for MACEs. A MACE was defined as a composite outcome that included all-cause mortality, myocardial infarction, or late revascularization. We employed an Automated Machine Learning (AutoML) approach to predict MACE using clinical, CCTA, and SPECT data. Various mainstream models with different sets of hyperparameters have been explored, and critical predictors of risk are obtained using explainable techniques on the global and patient levels. Ten-fold cross-validation was used in training and evaluating the AutoML model. A total of 956 patients were included (mean age 61.1 ±14.2 years, 54% men, 89% hypertension, 81% diabetes, 84% dyslipidemia). Obstructive CAD on CCTA and ischemia on SPECT were observed in 14% of patients, and 11% experienced MACE. ML prediction's sensitivity, specificity, and accuracy in predicting a MACE were 69.61%, 99.77%, and 96.54%, respectively. The top 10 global predictive features included 8 CCTA attributes (segment involvement score, number of vessels with severe plaque ≥70, ≥50% stenosis in the left marginal coronary artery, calcified plaque, ≥50% stenosis in the left circumflex coronary artery, plaque type in the left marginal coronary artery, stenosis degree in the second obtuse marginal of the left circumflex artery, and stenosis category in the marginals of the left circumflex artery) and 2 clinical features (past medical history of MI or left bundle branch block, being an ever smoker). ML can accurately predict risk of developing a MACE in patients suspected of CAD undergoing SPECT MPI and CCTA. ML feature-ranking can also show, at a sample- as well as at a patient-level, which features are key in making such a prediction.

Atherosclerotic Lesion of the Carotid Artery in Indonesian Cynomolgus Monkeys Receiving a Locally Sourced Atherogenic Diet.

The atherosclerotic lesion is a principal hallmark of atherosclerotic animal models. This study aimed to assess lesions of the carotid artery in Indonesian cynomolgus monkeys exposed to an IPB-1 atherogenic diet. A total of 20 adult male cynomolgus monkeys received the local IPB-1 diet for two years. Blood lipid profiles, morphology, and carotid ultrasound of monkeys were measured. Nine of them were euthanized to confirm atherosclerotic lesions. Common carotid arteries (CCA) and carotid bifurcation (BIF) samples were collected and stained using Verhoef-van Giessen and CD68 immunohistochemistry. The results reveal the presence of severe atherosclerosis plaques in six out of nine animals (66.7%) corresponding to intermediately and hyper-responsive groups. The hyper-responsive group displayed the highest response in the developing intimal area (IA) at the CCA (0.821 mm2), whereas the hyporesponsive group had the smallest IA (0.045 mm2) (p = 0.0001). At the BIF, the hyporesponsive group showed the smallest IA (p = 0.001), but there was no difference between the intermediately and hyper-responsive groups (p = 0.312). The macrophage marker CD68 was also expressed on the cartotid of the intermediately and hyper-responsive groups. These results indicate that severe atherosclerotic lesions with high infiltration of macrophages were formed in the carotid arteries of intermediately and hyper-responsive Indonesian cynomolgus monkeys fed with the local atherogenic diet IPB-1 over two years, thus confirming atherosclerosis in a nonhuman primate model.

Stable flow-induced expression of KLK10 inhibits endothelial inflammation and atherosclerosis.

Atherosclerosis preferentially occurs in arterial regions exposed to disturbed blood flow (d-flow), while regions exposed to stable flow (s-flow) are protected. The proatherogenic and atheroprotective effects of d-flow and s-flow are mediated in part by the global changes in endothelial cell (EC) gene expression, which regulates endothelial dysfunction, inflammation, and atherosclerosis. Previously, we identified kallikrein-related peptidase 10 (Klk10, a secreted serine protease) as a flow-sensitive gene in mouse arterial ECs, but its role in endothelial biology and atherosclerosis was unknown. Here, we show that KLK10 is upregulated under s-flow conditions and downregulated under d-flow conditions using in vivo mouse models and in vitro studies with cultured ECs. Single-cell RNA sequencing (scRNAseq) and scATAC sequencing (scATACseq) study using the partial carotid ligation mouse model showed flow-regulated Klk10 expression at the epigenomic and transcription levels. Functionally, KLK10 protected against d-flow-induced permeability dysfunction and inflammation in human artery ECs, as determined by NFκB activation, expression of vascular cell adhesion molecule 1 and intracellular adhesion molecule 1, and monocyte adhesion. Furthermore, treatment of mice in vivo with rKLK10 decreased arterial endothelial inflammation in d-flow regions. Additionally, rKLK10 injection or ultrasound-mediated transfection of Klk10-expressing plasmids inhibited atherosclerosis in Apoe-/- mice. Moreover, KLK10 expression was significantly reduced in human coronary arteries with advanced atherosclerotic plaques compared to those with less severe plaques. KLK10 is a flow-sensitive endothelial protein that serves as an anti-inflammatory, barrier-protective, and anti-atherogenic factor.

CurveletTransform-Based Texture Analysis of Carotid B-mode Ultrasound Images in Asymptomatic Men With Moderate and Severe Stenoses: A Preliminary Clinical Study.

The curvelet transform, which represents images in terms of their geometric and textural characteristics, was investigated toward revealing differences between moderate (50%-69%, n=11) and severe (70%-100%, n=14) stenosis asymptomatic plaque from B-mode ultrasound. Texture features were estimated in original and curvelet transformed images of atheromatous plaque (PL), the adjacent arterial wall (intima-media [IM]) and the plaque shoulder (SH) (i.e., the boundary between plaque and wall), separately at end systole and end diastole. Seventeen features derived from the original images were significantly different between the two groups (4 for IM, 3 for PL and 10 for SH; 9 for end diastole and 8 for end systole); 19 of 234 features (2 for IM and 17 for SH; 8 for end systole and 11 for end diastole) derived from curvelet transformed images were significantly higher in the patients with severe stenosis, indicating higher magnitude, variation and randomness of image gray levels. In these patients, lower body height and higher serum creatinine concentration were observed. Our findings suggest that (a) moderate and severe plaque have similar curvelet-based texture properties, and (b) IM and SH provide useful information about arterial wall pathophysiology, complementary to PL itself. The curvelet transform is promising for identifying novel indices of cardiovascular risk and warrants further investigation in larger cohorts.

Distribution and determinants of coronary artery calcium score in asymptomatic patients with diabetes in two different settings: Comparison between patients in continental France and La Reunion Island

Coronary artery calcium score (CACS) is increasingly used to refine the cardiovascular risk prediction in patients with diabetes worldwide. However, its distribution and determinants in this population remain controversial. We aimed to determine the CACS distribution and determinants in asymptomatic patients with diabetes and to compare them between Limoges and La Reunion and between sex groups. We used the medical records of patients with diabetes who had at least one CACS measurement between 2014 and 2020 in Limoges and La Reunion. CACS was classified into four categories (0: no plaque, 1–99: mild plaque, 100–399: moderate plaque, and ≥ 400: severe plaque). Multinomial logistic regression models were performed to determine the risk factors associated with each CACS categories. In addition, a risk score for having a CACS≥ 400 was created with the patients in Limoges and then tested on those in La Reunion. A total of 577 patients were analyzed (369 from Limoges and 208 from La Reunion). The highest proportion of high CACS was found in Limoges. The multivariate analysis showed that age (OR by 10 years = 3.82[2.45-5.97]), male sex (3.81[1.79-8.09]), diabetic retinopathy (3.45[1.29-9.20]), family history of cardiovascular diseases (3.23[1.44-7.25]) and statine use (3.71[1.25-11.0]) were independent risk factors for CACS≥ 400. The stratified analysis on sex and location showed that male patients had more risk factors for high CACS than female and that in both of the cities the factors associated with high CACS were approximately the same. Similarly, the performance of the created risk score assessed by the receiver operating characteristic curve showed approximately equal areas under the curve (AUC) between Limoges (AUC = 0.74) and La Reunion (AUC = 0.71). In this study, we found that regardless of location, patients with diabetes share the same risk factors for high CACS and that men have more risk factors than women.

Abstract 10824: High Bleeding Risk is Associated with a Higher Prevalence of Severe Calcified Plaque in Patients Requiring Percutaneous Coronary Intervention

Introduction: Optimal revascularization strategy and shorter duration of dual antiplatelet are required in patients with coronary artery disease concomitant with high bleeding risk (HBR). More complex percutaneous coronary intervention (PCI) and subsequent high thrombotic risk in patients with HBR have been also demonstrated. However, the characteristics of culprit plaque in patients with HBR remains to be elucidated. Hypothesis: HBR is associated with more complex plaque in culprit lesion in patients requiring PCI. Methods: A total of 362 consecutive patients with stable coronary disease, who underwent optical coherence tomography (OCT) imaging of the culprit lesion during PCI were included. The characteristics of culprit plaque assessed by OCT were compared between the HBR group (n=196) and the non-HBR group (n=166), which were classified based on the Academic Research Consortium for High Bleeding Risk (ARC-HBR). Results: The prevalence of severe calcified plaque (angle >180 degee, thickness >0.5mm and length >5mm) was significantly higher in the higher HBR group than in the non-HBR group (48 vs. 35%, p =0.016), although other characteristics were comparable (Panel A). Among patients with HBR, the incremental prevalence of severe calcified plaque according to the number of major ARC-HBR criteria met was observed ( p <0.001) (Panel B). Conclusions: HBR was associated with a higher prevalence of severe calcified plaque in culprit lesion in patients with stable coronary disease requiring PCI. The greater number of major ARC-HBR criteria met was associated with a higher prevalence of severe calcified plaque among patients with HBR.

Adverse coronary plaque characteristics are more common in patients with diabetes

Abstract Introduction Diabetes mellitus (DM) is associated with increased cardiovascular morbidity and mortality. However, there is a lack of data about the prevalence of adverse coronary artery plaques characteristics in patients with DM. Purpose In our study we aimed to compare the prevalence of adverse atherosclerotic coronary artery plaque characteristics between patients with and without DM. Methods We have analyzed the data of patients who underwent coronary computed tomography angiography (CCTA) between October 2012 and December 2020. Our exclusion criteria were coronary anomaly, congenital or other structural heart disease, previous revascularization or heart transplantation, non-diagnostic image quality and no available data on the presence of DM. Patients were divided into two groups based on the presence of DM. Results In total, 11,357 patients were included in our study. Prevalence of DM was 14.5%. There were significant differences in age (63.2±9.5 vs 58.1±12.2 years, p<0.001) and major cardiovascular risk factors such as hypertension, dyslipidemia and smoking between the two groups (all p<0.05). We have measured higher coronary artery calcium score in patients with DM vs. without DM (424.3±744.0 vs 174.2±794.6, p<0.001). Obstructive coronary artery disease (stenosis >70%) was more frequent in the DM group (24.6% vs 10.5%, p<0.001). While 29.6% of patients without DM had at least one plaque with adverse characteristics, this rate was 38.9% in those with DM (positive remodeling: 19.6% vs 26.1%, low attenuation: 7.6% vs 10.2%, spotty calcium: 16.9% vs 21.6%, napkin-ring sign: 1.7% vs 2.6%, all p<0.05). Conclusions The prevalence of severe coronary artery stenosis and coronary plaques with adverse characteristics was higher in patients with DM. Multivariate analysis is needed to further explore this association. Funding Acknowledgement Type of funding sources: None.

First identification of ITM2B interactome in the human retina

Integral Membrane Protein 2 B (ITM2B) is a type II ubiquitous transmembrane protein which role remains unclear. ITM2B mutations have been associated with different disorders: mutations leading to longer mutant proteins have been reported in two distinct Alzheimer-like autosomal dominant disorders with early-onset progressive dementia and cerebellar ataxia. Both disorders share neurological features including severe cerebral amyloid angiopathy, non-neuritic plaques, and fibrillary tangles as in Alzheimer disease. Our group reported a missense mutation in ITM2B, in an unusual retinal dystrophy with no dementia. This finding suggests a specific role of ITM2B in the retina. As the identification of retinal-specific ITM2B partners could bring new insights into the cellular functions of ITM2B, we performed quantitative proteomics of ITM2B interactome of the human retina. Overall, 457 ITM2B partners were identified with 8 of them involved in visual transduction. In addition, bulk Gene Ontology analyses showed that many ITM2B partners are involved in several other biological functions, such as microtubule organization, protein translation and interestingly, mitochondrial homeostasis. These data represent the first report of the ITM2B interactome in the human retina and may serve as a valuable inventory of new potential ITM2B partners for future investigations of ITM2B physiological functions and dysfunctions.

Utility of a Simplified Iliac Artery Calcium Scoring System to Guide Perioperative Management for Renal Transplantation.

Non-contrast computed tomography scans of the abdomen and pelvis (CTAP) are often obtained prior to renal transplant to evaluate the iliac arteries and help guide surgical implantation. The purpose of this study was to describe the association of iliac calcification scores with operative and clinical outcomes using a simplified scoring system. A retrospective review of 204 patients who underwent renal transplant from 1/2013 to 11/2014 and who had a CTAP within 3 years prior to transplant was performed. Data were collected from the electronic medical record. Common iliac artery (CIA) and external iliac artery (EIA) calcification on CTAP were assessed using a simple scoring system. Descriptive statistics, logistic regression, and survival analyses were performed. A total of 204 patients were included in the analysis. The mean age was 57.4 ± 11.2 years and 134/204 (66%) were men. Nineteen patients (9%) had a history of peripheral artery disease (PAD), 78 (38%) had coronary artery disease, and 22 (11%) had a previous cerebrovascular accident (CVA). Patients with severe right EIA plaque morphology were significantly more likely to require arterial reconstruction compared to those without severe plaque (3/14[21%] 4/153 [3%], p = 0.03). Eleven patients (5%) had one or more amputations (toe, foot, or transtibial) following transplant. In UV logistic regression, severe EIA plaque morphology (OR 8.1, CI 2.2–29.6, p = 0.002) and PAD (OR 10.7, CI 2.8–39.9, p = 0.0004) were associated with increased odds of amputation. In the MV model containing both variables, EIA plaque morphology (OR 4.4, CI 0.99–18.3, p = 0.04) and PAD (OR 6.3, CI 1.4–26.4, p = 0.01) remained independently associated with increased odds of amputation. Over a median follow up of 3.3 years (IQR 2.9–3.6), 21 patients (10%) had post-operative major adverse cardiac events (MACE, defined as myocardial infarction, coronary intervention, or CVA), and 23 patients died (11%). In unadjusted Kaplan Meier analysis, CIA plaque (p = 0.00081) and >75% CIA length calcification (p = 0.0015) were significantly associated with MACE. Plaque burden in the EIA is associated with increased need for intra-operative arterial reconstruction and post-operative lower extremity amputations, while CIA plaque is associated with post-operative MACE. Assessment of CIA and EIA calcification scores on pre-transplant CT scans in high risk patients may guide operative strategy and perioperative management to improve clinical outcomes.

Abstract 15301: Peripheral CD56 bright Natural Killer Cells Associate With Increased Atheroburden and Unstable Plaque Features in Humans

Background: Atherosclerotic plaques in mice and humans contain natural killer (NK) cells. Data on the role of NK cells in atherosclerosis using different transgenic mice models is inconsistent. Some studies showed that NK cells augment atherosclerosis through their cytotoxic potential, while others reported no effect. Evidence in humans indicates that NK cells are atherogenic. Frequency of NK cells and expression of the activating NK cell receptors are associated with severe disease and symptomatic carotid atherosclerotic plaques in humans. Hypothesis: We tested if coronary artery disease (CAD) subjects with necrotic plaques have a higher frequency of the circulating NK cells. Methods: We performed mass cytometry on peripheral blood mononuclear cells from matched CAD subjects with low and high (n=9 each) necrotic plaque content as determined by intravascular ultrasound-virtual histology. Results: CAD subjects with high necrotic plaques have significantly higher atheroburden, stenosis, calcium, fatty plaque content, and lower plaque fibrosis. Interestingly, CAD subjects with high necrotic plaques exhibited a significantly higher frequency of the CD56 bright NK cells as compared to those with low necrotic plaques (4.618 ± 0.625 vs 2.481 ± 0.37; p=0.011). Moreover, frequency of CD25 + NK cells also trended to be higher in subjects with high necrotic plaques. The frequency of the cytotoxic CD56 dim NK cells did not differ between the two groups. Correlation analyses demonstrated a significant positive association of CD56 bright NK cells with atheroburden (r=0.43; p=0.04), stenosis (r=0.58; p=0.005), plaque necrotic (r=0.71; p=0.002), calcium contents (r=0.73; p=0.0001), and a negative association with the plaque fibrous content (r=0.71; p= 0.0003). CD25 + NK cells also showed similar trending associations with burden, stenosis and plaque features. Conclusions: Our data provides yet another evidence of the atherogenic role of NK cells in humans and indicates that the CD56 bright NK cells may contribute to the development of a vulnerable plaque. CD56 bright NK cells produce proinflammatory cytokines including IFN-γ and TNF-α and cytotoxic enzymes that may contribute to increased inflammation, cell activation, and apoptosis within the plaque.

Neuropsychiatric Inventory-Assessed Nighttime Behavior Accompanies, but Does Not Precede, Progressive Cognitive Decline Independent of Alzheimer's Disease Histopathology.

The relationship between sleep, neuropathology, and clinical manifestations of Alzheimer's disease (AD) remains controversial. To determine whether nighttime behaviors (NTB) are associated with the development of AD histopathology or cognitive decline. We compared NTB prevalence in subjects with or without AD lesions, and with or without progressive cognitive decline. Subjects with either absent or severe plaques and tangles were identified from the National Alzheimer's Disease Coordinating Center data sets and classified as cognitively declining if the standard deviation from their individual mean Mini-Mental Status Examination score was ≥2, and stable if <2 regardless of their initial score. NTB was assessed using the Neuropsychiatric Inventory Questionnaire Quick Version (NPI-Q). NTB was significantly greater in decliners than stable subjects in the group with severe histopathology as determined by frequent plaques (p = 0.003) or high Braak stage (p = 0.002). A similar significant trend was observed in subjects with absent plaques (p = 0.019) or tangles (p = 0.006). The prevalence of NTB was comparable between stable AD and non-AD subjects. NTB severity scores showed a similar pattern. The development of NTB as assessed by NPI-Q in subjects with or without AD lesions occurred concurrently with cognitive decline. Among cognitively stable subjects, the presence of AD histopathology did not alter NTB prevalence. Thus, NTB disruptions at the gross granularity level assessed by NPI-Q were much more closely related to cognitive decline than the formation of pathological lesions. Factors other than AD histopathology may mediate the association between NTB and cognitive decline.

Halobetasol 0.01% Lotion in the Treatment of Moderate-to-Severe Plaque Psoriasis of the Lower Extremities

Abstract not available.

A Study to Evaluate the Efficacy, Safety, and Drug Concentration of Certolizumab Pegol (CZP) in Children and Adolescent Study Participants With Moderate to Severe Chronic Plaque Psoriasis (PSO)

A Study to Evaluate the Efficacy, Safety, and Drug Concentration of Certolizumab Pegol (CZP) in Children and Adolescent Study Participants With Moderate to Severe Chronic Plaque Psoriasis (PSO)

456Risk of arterial calcification by conventional vitamin K antagonist treatment

Abstract Background Vitamin K antagonists (VKA) are the most frequently prescribed oral anticoagulants worldwide although new oral anticoagulants (NOAC) have become an important alternative. VKA inhibits Vitamin K1 necessary to produce coagulation factors but also Vitamin K2, which is essential in the activation of matrix-Gla protein, thought to be a strong local inhibitor of arterial calcifications. Purpose The aim was to investigate, whether VKA treatment is associated with coronary artery calcification (CAC) in a population with no prior cardiovascular disease (CVD). Methods We collected data on cardiovascular risk factors and CAC scores from cardiac CT scans performed as part of clinical examinations (n=9,672) or research studies (n=14,166) in the period 2007–2017. Data on use of VKA and NOAC was obtained from the Danish National Health Service Prescription Database. The association between VKA treatment duration and categorized CAC score was investigated by ordered logistic regression while adjusting for covariates. The independent variables included in the model were: age, gender, smoking, body mass index (BMI), diabetes mellitus, hypertension, hypercholesterolemia and/or statin treatment, family history of CVD, estimated glomerular filtration rate, VKA treatment duration and NOAC treatment duration. The categorisation of CAC was: 0, 1–99, 100–399 and ≥400 AU, corresponding to no, mild, moderate and severe atherosclerotic plaque burden, respectively. Results The final study population consisted of 17,254 participants (median 67 years old, 75% males) with no prior CVD, of which 1,748 (10%) and 1,144 (7%) had been treated with VKA or NOAC, respectively. A longer duration of VKA treatment was associated with higher CAC categories (Figure). For each cumulative year of VKA treatment, the odds of being in a higher CAC category, i.e. having more severe atherosclerosis, increased (odds ratio (OR)=1.032, 95% CI 1.009–1.057). All traditional cardiovascular risk factors were also associated with CAC. In contrast, NOAC treatment duration was not associated with CAC category (OR=1.004, 95% CI 0.937–1.075). In a sensitivity analysis of patients without statin treatment (n=12,143), the association between VKA treatment and CAC category remained unchanged. There was no significant interaction between VKA treatment duration and age on CAC category. Conclusion Adjusted for cardiovascular risk factors, VKA treatment – in contrast to NOAC - is associated with more severe CAC. Additional studies are required to clarify the clinical importance of this association in terms of hard cardiovascular endpoints. Acknowledgement/Funding Novo Nordisk Foundation and Independent Research Fund Denmark

Efficacy of tildrakizumab patient subgroups across a phase 2b and 2 phase 3 trials in patients with moderate to severe chronic plaque psoriasis

Efficacy of tildrakizumab patient subgroups across a phase 2b and 2 phase 3 trials in patients with moderate to severe chronic plaque psoriasis

Observational Study of Patients With Moderate to Severe Chronic Plaque Psoriasis

Observational Study of Patients With Moderate to Severe Chronic Plaque Psoriasis

Histology of atherosclerotic plaque from coronary arteries of deceased patients after coronary artery bypass graft surgery

Background and aimIschaemic heart disease is an important health problem. The characteristics of atherosclerotic plaques determine patient outcome. The aim of this study was to determine the histological grade of coronary atherosclerotic lesions in deceased patients after coronary artery bypass graft surgery, and to identify the complications of the severe plaques. MethodA descriptive, cross-sectional, prospective study was carried out on 21 anatomical pieces of deceased patients over a period of 3 years. The epicardial coronary arteries were sectioned transversally every 1cm, and the odd numbered fragments and the regions of the anastomosis with the grafts were selected. They were embedded in paraffin, stained with haematoxylin-eosin, and the histological slides were studied using an Olympus BHM microscope. ResultsAn age over 50 years (85.7%), male gender (81.0%), and smoking (66.7%) predominated. Peri-operative infarction (38.1%) and cardiogenic shock (33.3%) were the main direct causes of death. The majority of the grafts were of venous origin (64.6%), and 149 lesions were detected, of which 116 (77.8%) were severe plaques, and 47.4% of them were located in the left anterior descending artery. The large majority (81.9%) of the lesions were located in the arterial segments proximal to the graft. A total of 255 histological complications were detected in the severe plaques, with 75.0% showing calcification. Hypertensive patients had more plaques with more complications, but no statistically significant association was found between these variables. ConclusionsSevere plaques predominated, mostly located in the proximal segments of the coronary arteries, and the left anterior descending was the most affected artery. Calcification was the most observed complication in the severe plaques.

Histología de la placa de ateroma en arterias coronarias de fallecidos después de una revascularización miocárdica quirúrgica

Background and aimIschaemic heart disease is an important health problem. The characteristics of atherosclerotic plaques determine patient outcome. The aim of this study was to determine the histological grade of coronary atherosclerotic lesions in deceased patients after coronary artery bypass graft surgery, and to identify the complications of the severe plaques. MethodA descriptive, cross-sectional, prospective study was carried out on 21 anatomical pieces of deceased patients over a period of 3 years. The epicardial coronary arteries were sectioned transversally every 1cm, and the odd numbered fragments and the regions of the anastomosis with the grafts were selected. They were embedded in paraffin, stained with haematoxylin-eosin, and the histological slides were studied using an Olympus BHM microscope. ResultsAn age over 50 years (85.7%), male gender (81.0%), and smoking (66.7%) predominated. Peri-operative infarction (38.1%) and cardiogenic shock (33.3%) were the main direct causes of death. The majority of the grafts were of venous origin (64.6%), and 149 lesions were detected, of which 116 (77.8%) were severe plaques, and 47.4% of them were located in the left anterior descending artery. The large majority (81.9%) of the lesions were located in the arterial segments proximal to the graft. A total of 255 histological complications were detected in the severe plaques, with 75.0% showing calcification. Hypertensive patients had more plaques with more complications, but no statistically significant association was found between these variables. ConclusionsSevere plaques predominated, mostly located in the proximal segments of the coronary arteries, and the left anterior descending was the most affected artery. Calcification was the most observed complication in the severe plaques.

Secukinumab-treated patients in the PURE registry (Patients with Moderate to Severe Chronic Plaque Psoriasis in Latin America and Canada): 12-month follow-up data

Secukinumab-treated patients in the PURE registry (Patients with Moderate to Severe Chronic Plaque Psoriasis in Latin America and Canada): 12-month follow-up data